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DSH320002C ST. VINCENT HOSPITAL (Active)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
Physicians Medical Center - OR Recovery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002C
Medicare Provider Number
320002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
3/12/2013
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
St. Vincent Hospital
Lillian Montoya, President and CEO
(505) 913-5258
Primary Contact
St. Vincent Hospital
Christine Atwell, Director of Pharmacy
(505) 913-5522
Addresses
Street Address
2990 Rodeo Park Drive East
Santa Fe, NM 87505
Billing Address
ST. VINCENT HOSPITAL
455 St. Michaels Drive
Santa Fe, NM 87505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/19/13 enrolled 4/1/13 thru 9/30/13, not enrolled 10/1/13 thru 12/31/13 due to failure to recertify, re-instated based on on-line registration submitted in Oct. 2013
11/19/2013
May 2025
May 2025
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